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Environmental lead exposure and progressive renal insufficiency
1Poison Center and Division of Nephrology, Chang Gung Memorial Hospital, 199, Tung Hwa North Road, Taipei, Taiwan, Republic of China. jllin99@hotmail.com
Archives of Internal Medicine
|February 15, 2001
Summary
Long-term, low-level environmental lead exposure subtly impacts kidney function, worsening progressive renal insufficiency. Lead chelation therapy significantly improved kidney function for over a year in affected patients.
Area of Science:
- Environmental Health
- Nephrology
- Toxicology
Background:
- Previous studies indicate an inverse relationship between serum creatinine/creatinine clearance and blood lead levels.
- Causality could not be directly inferred from prior research on lead exposure and kidney function.
Purpose of the Study:
- To investigate the relationship between body lead burden (BLB) and progressive renal insufficiency.
- To evaluate patients without a history of significant lead exposure.
Main Methods:
- A prospective, longitudinal study with a controlled clinical trial.
- 110 patients with chronic renal insufficiency and normal to high-normal BLB were followed for 2 years.
- Chelation therapy was administered to high-normal BLB patients post-follow-up.
Main Results:
- Fifteen patients experienced a 1.5-fold increase in creatinine; 14 were in the high-normal BLB group.
- Renal outcomes were significantly better in the low BLB group (P<.001).
- Body lead burden was identified as the primary risk factor for renal insufficiency progression; chelation therapy improved renal function.
Conclusions:
- Subtle, long-term environmental lead exposure may contribute to progressive renal insufficiency in the general population.
- Lead chelation therapy demonstrated sustained improvement in renal function for over a year.
- Further research is warranted to fully elucidate the role of lead in renal disease progression.